Organization
HEALTHSOURCE OF OHIO INC
Active
Other names
HealthSource: West Clermont
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH W PRATHER II MD (CEO)
(513) 707-4041
Entity
Organization
Contact information
Practice address
1341 CLOUGH PIKE, BATAVIA, OH 45103-2503
(513) 732-5085
(513) 214-2408
Mailing address
424 WARDS CORNER RD STE 200, LOVELAND, OH 45140-6966
(513) 707-4041
(513) 576-1020
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0260605
—
OH
Enumeration date
10/16/2017
Last updated
09/18/2024
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